Life is a constant succession of challenges. And those challenges seem to triple when you are handicapped. But the universal advice to confront life's challenges is the same for able and disables: SMILE!!!
So,
since I could not go to the pool to do my aquatic exercises I would like to at
least get a good night sleep. I
was now in year 18 of dealing with Muscular Dystrophy. My muscles were losing power by the day (or so
it seemed to me) I was finding it very difficult to turn myself one way or the
other while in bed. Not being able to change position is hard at any time but
at night, the darkness and the quietness made it terrifying. I began to have
very bad nights; I couldn't find sleep or even worse, in the little periods
when I went to sleep I would have nightmares which made me wake up screaming.
This very difficult situation made me think that I needed a special bed.
Someone told me Medicare would give handicapped people a hospital bed so I
started researching that idea.
I
found out that if you are a Medicare beneficiary enrolled in Original Medicare
(Part A and Part B) your Part B benefits may cover 80% of the allowable charges
for hospital beds after you meet your Part B deductible. YOUR doctor,
as well as the durable medical equipment (DME) supplier must participate in the
Medicare program. Getting Medicare to cover a hospital bed at home is not a process you get done in one day. First, a doctor must deem the hospital bed necessary, and therefore, prescribe it for use in an individual’s home. Prior to being issue with a prescription for the hospital bed the patient will have to be submitted to a face to face evaluation with a physician’s assistant, nurse practitioner, clinical nurse specialist, or physician. During this encounter, the physician or practitioner must document in the patient’s medical record: 1. An in person face-to-face examination with the treating practitioner (Medical Doctor (MD), physician assistant (PA), nurse practitioner (NP) or clinical nurse specialist (CNS)) and, 2. The treating practitioner must document that the beneficiary was evaluated and/or treated for a condition that supports the need for the item(s) of DME ordered; and, 3. The face-to-face examination must have occurred sometime during the six (6) months prior to the date of the order for the item.
Also, since Medicare does not pay for full-electric hospital beds under just any circumstance, The following qualification criteria need to be documented in the patients’ medical record notes to qualify for the prescribed equipment. Note: face to face and justification notes are valid for six months.
Electric hospital bed: One of 1-4 AND 5 need to be sufficiently documented to support the need for the prescribed equipment.
1. Explain the patient’s medical condition that requires positioning of the body in ways not feasible with an ordinary bed. Note: Elevation of the head/upper body less than 30 degrees does not usually require the use of a hospital bed. Or
2. Explain why the patient requires positioning of the body in ways not feasible with an ordinary bed in order to alleviate pain. Or
3. Explain why patient requires the head of the bed to be elevated more than 30 degrees most of the time due to congestive heart failure, chronic pulmonary disease, or problems with aspiration: Or
4. Explain why the patient requires traction equipment, which can be attached to a hospital bed. AND
5. Explain why the patient requires frequent changes in body position and/or has an immediate need for a change in body position. (https://homehealthunited.org/professional/hme/documentation-needs/electric-hospital-bed/)
In order to expedite the process it is imperative for the patient or family to find a reliable supplier. Working with an experienced supplier of durable medical equipment (DME), who is well aware and knows the Guide to Medicare Coverage will increase your chances of getting coverage in a timely manner.
It is VERY IMPORTANT that the patient that is going to use the bed pays a lot of attention when choosing the kind of mattress. Please stay tuned for my next post discussing about different types of mattresses.
1. Explain the patient’s medical condition that requires positioning of the body in ways not feasible with an ordinary bed. Note: Elevation of the head/upper body less than 30 degrees does not usually require the use of a hospital bed. Or
2. Explain why the patient requires positioning of the body in ways not feasible with an ordinary bed in order to alleviate pain. Or
3. Explain why patient requires the head of the bed to be elevated more than 30 degrees most of the time due to congestive heart failure, chronic pulmonary disease, or problems with aspiration: Or
4. Explain why the patient requires traction equipment, which can be attached to a hospital bed. AND
5. Explain why the patient requires frequent changes in body position and/or has an immediate need for a change in body position. (https://homehealthunited.org/professional/hme/documentation-needs/electric-hospital-bed/)
In order to expedite the process it is imperative for the patient or family to find a reliable supplier. Working with an experienced supplier of durable medical equipment (DME), who is well aware and knows the Guide to Medicare Coverage will increase your chances of getting coverage in a timely manner.
In order to expedite the process it is imperative for the patient or family to find a reliable supplier. Working with an experienced supplier of durable medical equipment (DME), who is well aware and knows the Guide to Medicare Coverage will increase your chances of getting coverage in a timely manner.
It is VERY IMPORTANT that the patient that is going to use the bed pays a lot of attention when choosing the kind of mattress. Please stay tuned for my next post discussing about different types of mattresses.
ARTICLES YOU MIGHT LIKE TO READ
https://medicare.com/coverage/medicare-cover-hospital-beds/https://dmeevalumate.com/CMS
LOOKING BACK
I should had looked into getting a hospital bed
earlier
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